Achieving Continence with a Neurogenic Bowel

Leibold, Susan

doi:10.1016/j.pcl.2010.08.002

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…As previously noted, various medical and surgical interventions are available to treat neurogenic bowel and bladder in spina bifida . Our data add to existing literature by highlighting associations between continence and various interventions in a young cohort.…”

Section: Discussionsupporting

confidence: 78%

“…As previously noted, various medical and surgical interventions are available to treat neurogenic bowel and bladder in spina bifida. [3][4][5][6][7] Our data add to existing literature by highlighting associations between continence and various interventions in a young cohort. Extant research tends to examine treatment outcomes by looking at patients served through a single clinical center 19 or by emphasizing outcomes of one single intervention.…”

Section: Discussion Body Structure Function Approachsupporting

confidence: 56%

“…Bowel and bladder incontinence have the potential to impose significant limits on a person's activity and participation in daily activities. A variety of medical and surgical interventions are currently available to treat neurogenic bowel and bladder impairments . Unfortunately, few prospective studies that evaluate their long term efficacy and safety exist.…”

mentioning

confidence: 99%

“…A variety of medical and surgical interventions are currently available to treat neurogenic bowel and bladder impairments. [3][4][5][6][7] Unfortunately, few prospective studies that evaluate their long term efficacy and safety exist. Because of the differences in incontinence management across regions and among practitioners, a standard of care for children with spina bifida has not been established, 8 which has led to variation in care across centers treating individuals with spina bifida.…”

mentioning

confidence: 99%

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The effectiveness of bowel and bladder interventions in children with spina bifida

Smith

Neville-Jan

Freeman

et al. 2016

Develop Med Child Neuro

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Disability and Health (ICF), the aim of this study was to identify effective strategies for managing urinary and bowel complications resulting from spina bifida.METHOD Charts of 210 children between 4-and 13-years-old with spina bifida were reviewed to quantify medical interventions and continence status. Standardized quality of life (QOL) questionnaires were administered to a subset of participants; child and parent interviews were carried out to examine the experience of living with bowel and bladder incontinence. Practitioners were also interviewed to understand their perspectives of intervention effectiveness.RESULTS Chart review indicated less than half of children were continent for bowel and bladder. More variability existed in bowel continence programs, and practitioners considered bowel continence more difficult to achieve than bladder continence. No significant associations were found between continence status and QOL measures. Interviews, however, reflected how managing continence at home and school more broadly affects QOL. Among practitioners, some focused primarily on optimizing physical health while others focused on activity and participation.INTERPRETATION While continence is a goal, programs used to achieve this are individualized and outcomes may be affected by differential treatment effects, environmental factors, and/or stigma experienced by children.Spina bifida results from an incomplete neural tube closure during embryonic development. A direct link exists between the location of the lesion and the resulting impairments associated with spina bifida: sensory, neurological, orthopedic, bowel and bladder, and cognitive. More than any other factor, bowel and bladder impairments can result in profound social stigma and decreased self-esteem, as well as serious health complications, including death.

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Section: Discussionsupporting

confidence: 78%

Section: Discussion Body Structure Function Approachsupporting

confidence: 56%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The effectiveness of bowel and bladder interventions in children with spina bifida

Smith

Neville-Jan

Freeman

et al. 2016

Develop Med Child Neuro

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“…In adults with central nervous system diseases, there are no current evidence‐based recommendations for faecal incontinence management . Current management favours an individually tailored, stepwise approach: typically, a form of RCE, in our study of Peristeen, is part of a conservative bowel management and is trialled after failure of conventional treatment, including toileting routines and laxatives . Surgical procedures, including formation of appendicostomy, resection of megarectosigmoid or formation of colostomy, may be considered in patients unsuccessfully managed conservatively .…”

Section: Discussionmentioning

confidence: 99%